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Welcome from the CEO

Welcome to the first edition of our new-look AHPRA report. We have redesigned the newsletter to bring you what we think are the most interesting, informative and relevant stories about AHPRA and the National Registration and Accreditation Scheme (National Scheme).

There are now over 633,500 registered health practitioners in Australia. The national online register of practitioners is central to all of our work because it provides up to date information about every registered health practitioner. To help the public and employers get the most out of the register, we have published simple tips on using the register. In particular, the tips remind anyone responsible for recruiting health practitioners how to use the register to verify a practitioner’s registration status.

In this newsletter, we highlight further steps we are taking to improve public and patient safety. This includes new and strengthened procedures for checking the international criminal history of applicants for registration. We’ve also taken a close look at how we can improve our communication with consumers and practitioners, particularly around notifications/complaints. See our Focus on public safety for these stories.

Over the past year we have launched a statement of our regulatory principles shared with all National Boards. The principles encourage a responsive, risk-based approach to regulation and support consistent, balanced decision-making. We are now seeking your feedback through an online survey on the regulatory principles.

An important focus of our regulatory principles is on developing risk-based approaches to our work. AHPRA is strengthening the foundations for contemporary evidence-informed approaches to risk-based regulation and has begun a range of analytical projects for National Boards. You can read about this in our Research news.

We’ve completed a lot of updates and improvements to our websites and online services for the public and practitioners to make their experience a better one, and to protect confidential information – and that work continues. See New digital projects for details.

AHPRA Agency Management Committee Chair, Michael Gorton AM, is profiled in this edition and he has many perceptive comments to offer on the National Scheme’s progress and future.

We welcome your feedback on the issues and stories we cover in this newsletter, National Boards’ public consultations and the regulatory principles that underpin decisions about health practitioner regulation in the National Scheme. If you’d like to have your say, please see these stories to find out how.

We will publish AHPRA report three times a year. Look out for the next issue in winter 2015.

Hot topics

Health and Care Professions Council – what can we learn from the UK?

AHPRA and the National Boards are interested in learning from the experience of other regulators, both in Australia and internationally. Dr Anna van der Gaag CBE, Chair of the Health and Care Professions Council (HCPC), is a recognised leader in multi-profession practitioner regulation. The HCPC regulates health, psychological and social work professionals in the UK. This includes professions that are regulated through the National Scheme, such as podiatry, occupational therapy, physiotherapy and psychology.

The HCPC regulates 332,000 registered practitioners. The HCPC’s use of research and evidence to inform its work, ISO certification as a key quality assurance process and an integrated system of regulation underpinned by values such as transparency are areas that interest the National Boards and AHPRA.

Dr van der Gaag’s visit to AHPRA in February also highlighted the HCPC’s proactive approach to regulation, including its focus on accessibility and dialogue. This includes the use of social media to reach and engage with the concerns of stakeholders – the professions, the public, educators, professional associations and the media. These experiences are of great interest as AHPRA is progressively expanding its social media presence.

National Boards and AHPRA are keen to draw on relevant examples of good practice from the HCPC experience as a well-established multi-profession regulator to benefit the National Scheme. AHPRA and the HCPC are building ongoing relationships and other links, including through the development of an exchange program.

Focus on enhancing public safety

Over the past few months, AHPRA and the National Boards have launched a number of initiatives aimed at improving public safety.

New approach to international criminal history checks

A new procedure for checking international criminal history that provides greater public protection took effect in February. This approach requires certain applicants and practitioners to apply for an international criminal history check from an AHPRA-approved supplier. The supplier will provide the report to the applicant and directly to AHPRA.

The new process aligns our international criminal history checks with our domestic history checks and aims to be fair and reasonable for practitioners. Under the National Law, National Boards must consider the criminal history of an applicant who applies for registration, including any overseas criminal history.

Strengthening national screening for drugs

We are introducing a new screening protocol to ensure drug screening in the National Scheme is consistent with the latest evidence and up to date. Under the protocol, all health practitioners who have restrictions on their registration linked to past substance abuse will have routine hair testing in addition to urine testing.

Routine hair testing helps provide comprehensive information about the use – over time – of a wide range of drugs (not just those based on the practitioner’s drug-taking history).

Publication of tribunal outcomes

Since 2014, AHPRA has been publishing media releases summarising the outcomes of tribunal decisions relevant to health practitioner regulation under the National Scheme. They provide useful and timely reminders about issues that have led to complaints and notifications and subsequent action in relation to practitioners. These summaries are the most popular content that we share on Twitter.

AHPRA actions to improve consumer and practitioner experience

Improving the experience of people who have made a notification has been a focus for us since early last year, when we commissioned the Health Issues Centre of Victoria (HIC) to undertake targeted research into the consumer experience when making a notification.

Since then we have made a raft of changes to address the issues this research raised, in particular to make our written communication clearer and easier to understand.

We recently started work on improving the practitioner experience of notifications. Earlier this month, senior leaders from AHPRA and the Medical Board of Australia (MBA) met Australian Medical Association (AMA) leaders about the way we manage notifications – including decision-making protocols, guidance and policies.

Key issues include the time it takes for a notification to go through the process; the tone and clarity of our communication; the need to better explain how the process works and why, and greater transparency wherever legally possible.

We will continue working on addressing the HIC’s recommendations, and on other activities that will improve the overall experience of both consumers and practitioners who are the subject of a notification.

New digital projects: improving our communications

Our websites are our main link with registrants, applicants for registration, students, employers, government and the public. We have completed several projects to make online interactions easier and provide crucial information to new graduates registering for the first time.

AHPRA and Board website improvements include reviews of content for consistency and a new, clearer homepage design across all our sites, launched in August 2014. Work on the review and improvements to our sites will continue throughout this year, and includes extensive consultation with a range of user groups including practitioners, employers and members of the community.

Security alert

From early April 2015, anyone using the browser Internet Explorer version 6 (or an older version) is likely to experience difficulty accessing our websites or using our online services, as we will no longer be supporting it. This change is in response to a worldwide alert about the security service on the program, which could put users’ information at risk. Please make sure you update your web browser regularly to better protect your data.

New service for graduates

The Psychology Board of Australia has introduced a web portal for candidates sitting the National Psychology Examination, which must be passed before they can gain general registration.

AHPRA and social media

AHPRA and the National Boards have continued expanding our social media activities. Recently, we have launched our Facebook Page to engage with stakeholders alongside our Twitter and LinkedIn accounts.

Through our social media accounts, we have engaged with stakeholders across the National Scheme, including practitioners, students, members of the public and the media. We share information about the latest AHPRA and National Board news, and provide customer service for incoming enquiries.

Over time, we are working to expand our use of social media for consultations and feedback, such as our #AHPRAqanda sessions.

AHPRA’s advisory groups

AHPRA’s two external advisory groups help us understand and connect better with our registrants and the wider community. These groups do not discuss individual registration or notifications matters. Both groups publish communiques on the AHPRA websites after their meetings.

Community Reference Group

In 2015, the CRG will continue to provide advice on emerging issues, engaging the community, operational improvements that may benefit or affect the community and developing plain language information.

Professions Reference Group

AHPRA’s Professions Reference Group (PRG) provides feedback, information and advice on strategies for building better knowledge from within the professions about health practitioner regulation, and advises AHPRA on issues affecting the professions.

Call for views on our regulatory principles

National Boards and AHPRA are seeking feedback through an online survey* on the regulatory principles that were launched in July last year.

The Regulatory principles describe the National Boards and AHPRA’s approach to regulation. The principles encourage a responsive, risk-based approach to regulation and support consistent, balanced decision-making. The aim of the principles is to foster a considered approach to regulation, reducing the risk of unnecessary and ineffective regulatory action, and focussing resources on areas where the result is harm minimisation. We are inviting members of the public, health consumers, health practitioners and all interested persons to share their views on our regulatory principles through this brief survey. The survey has 11 questions and should only take about five to ten minutes to complete.

The responses to these surveys will inform the ongoing implementation of the principles and how they could be further developed and improved.

Complete the survey by 9am Monday 18 May by following the link above*

*Privacy: When you click on this link, you will be taken to a survey on a third party website, hosted by SurveyMonkey. AHPRA is conducting the survey. The survey is anonymous. Responses to the survey will be used to review the Regulatory principles for the National Scheme. The information you provide will be handled in accordance with the privacy policies of Survey Monkey accessible here. Information AHPRA obtains from the survey will be handled in accordance with our Privacy policy.

Health workforce update

Research news

AHPRA’s research and data access

Data gathered about health practitioners through the regulatory process has workforce-planning, demographic, and research value. We are receiving an increasing number of requests for access to de-identified data from a wide range of stakeholders.

The National Law* and the Privacy Act 1988 (Cth) impose strict limits on how we use this data. We have developed the Data access and research policy to maximise the benefits that data access can bring, while managing risks to the privacy of practitioners. The Strategic Data Access and Research Committee (SDARC) considers data access and research requests and makes recommendations on whether applications meet the criteria for release.

*The Health Practitioner Regulation National Law, as in force in each state and territory.

Risk-based regulation

AHPRA is strengthening the foundations for contemporary evidence-informed approaches to risk-based regulation and has begun a range of analytical projects for National Boards.

The program has been inspired by risk-based regulation expert Professor Malcolm Sparrow, who challenges regulators to take a problem-centric approach to preventing harm rather than the more traditional program- or function-centric approach to regulation.

According to Professor Sparrow, ‘Discerning the parts or components of a problem, studying their structures and dynamics quite carefully, until you can see what it will take to unravel or “sabotage” them, and then skilfully undoing the parts, one by one – that’s the art I try to teach, because that’s the new professional practice that we observe emerging.’

This approach enables regulators to respond to risk in an appropriate manner – the concept of ‘right-touch regulation’, now incorporated in the National Scheme’s regulatory principles.

Identifying hot-spots of risk to improve healthcare quality and safety

We’re all familiar with the way chronic illnesses like heart disease are targeted through prevention campaigns. Why wait until there is a crisis when you can understand the groups of people most at risk and find ways to reduce the likelihood of harm?

AHPRA and the National Boards are working with the University of Melbourne to use data to track risks and prevent harm. This new, three-year research partnership, jointly funded with the National Health and Medical Research Council (NHMRC), takes elements of this preventive approach and applies it to identifying patterns of risk. The partnership is an important part of developing our risk-based approach to regulation of health practitioners.

What’s new in our sector

There are many relevant publications available on the websites of other regulators, related bodies and professional journals, here and overseas. Here are links to several recent ones.

Lessons from the Coroner

The Victorian Institute of Forensic Medicine (VIFM) has relaunched its Clinical communiqué – a newsletter written by clinicians, for clinicians, about lessons learned from deaths investigated by coroners’ courts. The first two editions of the communiqué are available on the VIFM website. Subscription is free and available at VIFM Communiqués.

Competence, professionalism and engagement in the health professions

The Health and Care Professions and Council UK (HCPC) has released a research report: Preventing small problems from becoming big problems in health and care. You can access the report, and other publications, on the HCPC website.

New research on GMC decisions about doctors under investigation

The General Medical Council UK (GMC) has recently published an independent review of its decision-making during its investigations into doctors who have been the subject of a serious complaint. Read the press release and access the report on the GMC website.

National study report: predicting the risk of recurrent patient complaints

A new report on predicting doctors’ risks of formal patient complaints, based on Australian data, can be found on the BMJ Quality & Safety website.

In conversation with…

Michael Gorton AM, Agency Management Committee Chair

Tell us about your role with the AHPRA Agency Management Committee and what the transition from committee member to chair has meant for you.

Having been involved with AHPRA since its inception, as a member of the Agency Management Committee, I have seen our ups and downs. I am delighted with the progress we have made in recent years, the result of a great effort from all of our staff and management. My appointment as chair has given me greater visibility of the diversity of work across our offices and the great achievements of our people. As chair I have been involved in an enhanced role of stakeholder engagement, meeting health ministers, health department and professional association representatives and many others to promote the work and success of AHPRA. I think we may have changed some perceptions about our role and success.

What key achievements have been realised in the past 12 months in the implementation of the National Scheme?

As chair I have promoted three main pieces of work, which we are successfully rolling out:

demonstrable improvements in our performance and measurement of our performance to convince our stakeholders that we are meeting our aims

improving the experience of notifiers and practitioners, with simpler language, regular communication and better information about our processes, and

responding to the three-year review of the National Scheme.

It is good to now be receiving acknowledgment from those outside the National Scheme of our successes in these areas.

When will we know that improvements in the experience of notifiers and practitioners have been successful?

Given the work we are undertaking to improve the experience of notifiers and practitioners, we will need to follow up with surveys and forums to ensure that we have made a difference, and that we continue to do so in the future. I would like to think that those involved in notifications, both notifiers and practitioners, feel that they have been listened to, had their views carefully considered and can see the sense in the decisions we make.

How is AHPRA working with health sector stakeholders to get the most out of the National Scheme?

Stakeholder engagement is limitless! Our work covers such a wide variety of the health sector and government that there are an endless number of people who need to understand what we do and how we do it. We have strong links to community representatives who give us frank advice on public perception and community expectation. We are regularly liaising with professional representatives to ascertain their views. We must, of course, fully engage with government at all levels to explain our work and deal with the many sensitive issues that arise. By explaining our work, sharing our achievements and, in a timely way, advising when things go wrong, we hopefully build trust and confidence, both in AHPRA and the National Scheme.

What will the outcomes of the National Scheme review mean for its future?

The National Scheme review has looked at a wide range of issues. It sought commentary on some structural changes to the scheme, including the possibility of greater multi-professional approaches.

It will have explored our success in notifications, and I hope we have communicated the great advances and improvements that we have been making in the last year or two. I hope that the review recognises and endorses our achievements and improvements, as well as making constructive suggestions on the way we can improve the scheme in the future.

What are the main opportunities the review outcomes will offer to AHPRA and the National Boards?

The review has enabled all of the parts of the scheme to express their views in relation to the issues raised. The Agency Management Committee, as well as National Boards, have been able to clearly give our views on multi-professional approaches (some of which we are already implementing), as well as identifying parts of the national legislation which can certainly be improved. I hope the review recognises that AHPRA and the National Boards work successfully together and that any future framework enables us to continue to collaborate and drive the National Scheme further.

What are the opportunities and challenges to be focused on in the next 12 months?

We must continue to build confidence in our performance. We still have a way to go to better explain our role and processes. Some notifiers and practitioners still have unrealistic expectations of what we can and cannot achieve. We will need to respond to the recommendations from the National Scheme review to ensure that we get a workable and constructive outcome – one that allows us to do our job better.

We must always remember that we represent and are here to protect the public interest. We are accountable to government and to the professions generally, although we must be independent and fearless in undertaking our roles. I hope that we, therefore, earn the respect of our stakeholders, who recognise the hard work that we do and recognise our successes as well as our occasional failures.

What can be learnt from international regulators?

We have been continually trying to improve and learn from the approaches taken by others. We have successfully engaged with international regulators to find ways to do our job better. Key staff have engaged in international conferences, and we have had some significant visits in Australia from representatives of regulators in other jurisdictions, including the United Kingdom. While we are all different, there are common threads in the way we approach our work, and we can learn from alternative approaches and processes that have been successfully used overseas. We recently had the chair of the multi-professional regulator in the UK, who gave a wealth of information on how a multi-professional approach can succeed, as well as some of the pitfalls.

What do you think AHPRA and the National Boards should have succeeded in achieving in five years’ time?

We should never be complacent, and we should strive to improve. I hope that in five years’ time we will all think the National Scheme is ‘boring’. I hope that everyone will respect us for the job we do, recognise the hard work that it involves, and feels confident that we are able to meet all of our objectives and roles. I would like the National Scheme to be a successful model of professional regulation that is envied by others overseas and valued by our stakeholders locally.

What is the single most important thing you would like to achieve during your term as chair?

I hope that we will have demonstrably improved our performance in the time taken to properly deal with registration and notification matters. I hope we will have demonstrated value to the professions for the fees that they pay, and I hope that the public generally (and even the media) respect us for the work that we do.